Bridging the Gap: Adopting ORNAC Standards in Cardiac Catheterization Lab at the Maritime Heart Centre

Abstract:

Restructuring of the Cardiac Catheterization Lab at the Maritime Heart Centre introduced several new surgical procedures to meet the demands of the current patient population. Pacemaker/ICD insertion, TAVI, and congenital closure devices being introduced required a revitalization of procedural practices by nursing staff. The need for enhanced practice lead us to implement ORNAC standards to optimize procedural patient outcomes.

About the speaker(s):

Ms. Andrea Muenster, BN,


Collaborative Partnerships for Excellence in Perioperative Education

Abstract:

Alberta Health Services (AHS) and MacEwan University have been working together since 2014 to provide perioperative education for RNs and LPNs. A unique component of this joint offering is brokered instruction, where an AHS employee instructs a portion of the program to learners who have been hired by AHS. This relationship provides a customized learning experience, heightens the relevance of the program to the workplace, and meets the demands of AHS workforce planning.

A collaborative evaluation of the program was designed and established in Fall 2017 to assess the effectiveness of the program in preparing LPNs to practice in the operating room (OR). This evaluation focused on the perceptions of graduates and mangers related to effectiveness, ability to practice safely, and ability to integrate ORNAC standards in the workplace. Program strengths and areas for growth have been identified and this poster presents the results and highlights next steps.

About the speaker(s):

Ms. Rana Sleiman, RN BScN CPN(C), Alberta Health Services


Changing Tides and Making Waves in Perioperative Nursing Education

Abstract:

Through 2016-2017, the tide brought about exciting change to our perioperative nursing education program, and it was transformed into what is now known as RPEP (Regional Perioperative Education Program). A formal curriculum review, including a literature review and Pan-Canadian Environmental scan on perioperative nursing education programs, set the stage for the beginning of our educational paradigm shift. In shifting from a traditional lecture style format to a web-based, collaborative, learner-centred approach we are better able to meet the needs of our students, the organization, health human resource forecasting and provincially mandated surgical care strategies. RPEP utilizes AORN’s Periop 101: A Core Curriculum™ within a curriculum philosophy that combines Benner’s Novice to Expert theory, constructivism, and principles of adult learning to actively engage student learning. Our presentation will review the challenges associated with bringing a new and innovative evidenced based program to fruition, while juggling the needs of the various stakeholders. 

About the speaker(s):

Ms. Heather Martin, BScN RN CPN(C), Vancouver Coastal Health


Why Join a Nursing Specialty Group?

Abstract:

Nursing specialty groups, such as perioperative nursing are committed nurses sharing similar interests or a passion who join together to form a group, or pursue membership in an established specialty nursing group. The desired personal result is to enrich knowledge, skills and care provided to patients who fall under a particular specialty.

What are the benefits?

A shared passion for this particular type of nursing,

The ability to network and share information with other like nurses,

Information sharing, information gathering, and

Ability to link with like-minded nurses locally, regionally, provincially/territorially, nationally and internationally are a few reasons to join or form a specialty nursing group.

This poster will visually link the goals and benefits in a nursing specialty locally thru to international connections such membership shall provide a perioperative registered nurse.

About the speaker(s):

Ms. Margaret Farley, RN,


Tides of Change: A Journey in Anesthesia Nursing Practices

Abstract:

The basis of this project is to create a poster displaying historical markers from the inception of anesthesia practices used in Canada until the present day. A variety of facts, pictures, and photographs will be used to catalog historical anesthesia practices that have shaped the specialty of perioperative nursing. My approach is to create an aesthetically pleasing collage that will encompass the annals and the essence of perioperative nursing through a visual journey.

About the speaker(s):

Ms. Eyke Howard, Registered Nurse,


The Nurse's Role as Laser Safety Officer and its Impact on Patient and Staff Safety

Abstract:

According to the Ontario Ministry of Labour and the Occupational Health and Safety Act, an employer must appoint an individual who is comptetent and knowledgeable in laser safety to ensure all precautions are taken to protect employees and patients from hazards of lasers. I am a registered nurse who was selected by my clinical manager the critical responsibility of being the medical laser safety officer at McMaster Children's Hospital in Hamilton, Ontario. In the operating room setting, nurses fulfill many important roles with the use of laser and other technologies. These roles and functions change based on the type of procedure, where the treatment occurs, and the educational level and advanced skills of the nurse. This role brings a unique set of responsibilities that I would not have experience otherwise. Some of these responsibilities include ensuring my nursing colleagues receive the required knowledge, skills and judgement to provide laser therapy in a safe and ethical manner, risk management, implementation of a laser safety program, participation in laser safety committee meetings, and collaboration with laser technicians regarding maintenance and repairs. I plan to present my experience as laser safety officer including my contributions to patient and staff safety, as well as how this role has changed and evolved my nursing practice.      

About the speaker(s):

Ms. Joanna Hojnic, RN, Hamilton Health Sciences


Patient Driven Goal Setting Tool Within the Total Joint Replacement Journey: Aligning Three Organizations

Abstract:

The Champlain LHIN, the Montfort and Queensway Carleton Hospital, through an extensive quality improvement initiative, created a patient driven goal setting tool within the total joint replacement journey, in hopes of aligning our practices and focusing on a more patient centered approach

Method

We used various diagnostic tools and strategies to determine the most common causes of discharge, and found it all led back to patient function. Based off of this, we created our tool and trialed it at various times throughout the patient journey. Patient and practitioner reported outcome measures (PREMs) where used to gather feedback. We also examined over 230 goals to look for common themes.

Results

Patients agreed that the tool engaged conversation with their surgeon. 100% of patients thought that setting their own goals motivated them to work harder, and 93% thought it had made a difference in the end result of their physiotherapy. Surgeons agreed on the importance of discussing goals preoperatively (88%). Physiotherapists were more divided with only 50% top box, mentioning time and lack of specificity of goals as barriers.  Goals were divided into 32 categories, with the top three being: No pain with walking (35%), increase leisure activities (17%) and pain-free (15%).

Conclusion

Our project confirmed that patient’s goals can vary greatly and that it is important to look at each person individually. We feel the tool should be utilized at  the initial surgical appointment, then follow the patient through to the rehabilitation phase.

About the speaker(s):

Mrs. Mélanie Farmer, PT, Hôpital Montfort


Using a Clear Drape to Visualize the IV Sites During Surgery

Abstract:

 The operating room (OR) at SickKids has been challenged with intra-op management of peripheral intravenous lines (PIV). In the last few years, this issue has been emphasized due to several serious safety events that have resulted in significant patient injuries, caused by interstitial PIVs. Part of the challenge is associated to decrease visibility of the PIV site due to the standard blue surgical drapes. To mitigate patient risks of acquiring an interstitial PIV intra-op,Sickkids collaborated with manufacturers to develop an innovative clear drape. At the time, a clear drape was not available. In early summer 2018, the clear drape was made available for use in the OR. During Huddle, the team will discuss whether the clear drape is appropriate based on the patient and the set criteria. 

The PIV sites are visible throughout the procedure and the team is able to perform hourly visual assessment of PIVs and subsequently avoid the preventable PIV injuries. A secondary benefit of using the clear drape and having visibility of the patient is that it prevents pressure injuries caused by placement of instruments or staff position (i.e. leaning).

About the speaker(s):

Mrs. Aline Titizian, RN, BScN, Sick Kids


Using virtual reality for perioperative nursing education in  craniotomy procedures

Abstract:

An over reliance on real-time training in perioperative nursing education has resulted in lengthy orientations, staffing challenges, and difficulties with maintaining clinical skills. This problem is prevalent in neurosurgery, due to the lack of consistently scheduled procedures. Approximately 45% of neurosurgery cases at the Hospital for Sick Children are emergencies, which makes it difficult to organize education. Severely limited training opportunities have resulted in a lack of confidence, and an unwillingness to assist in these surgeries particularly as the scrub nurse. Virtual reality (VR) is an innovative teaching strategy that has the capacity to provide consistent and realistic training opportunities. To address this education gap, a VR craniotomy simulation was developed where the user is embedded into the scenario as the scrub nurse and is expected to assist in the procedure. Participants are able to develop clinical competencies in craniotomy procedures as the scrub nurse, with opportunities to practice clinical skills, apply critical reasoning, and receive feedback. 

About the speaker(s):

Mrs. Linda Nguyen, RN, MN, Hospital for Sick Children


Disaster in the OR: Are You Prepared?

Abstract:

Disasters, whether natural or human caused, are increasing in frequency and severity. Hospitals, including operating rooms, rely heavily on electricity for day-to-day activities. Is your hospital or operating room prepared to deal effectively with a disaster without compromising patient care? What can you do, as an individual or as a group, to prepare for a disaster? Hospitals are in the unique position that they may have to continue to provide patient care with reduced resources and equipment during and after a disaster. Emergency preparedness drills and exercises ensure that staff know their roles and responsibilities during a disaster, resulting effective teamwork and better patient care during a stressful and chaotic time. 

About the speaker(s):

Ms. Michelle Lord, RN, Alberta Health Services


Because We have always done it that way

Abstract:

Have you ever given care to a patient or client that wasn’t in their best interest just “because we’ve always done it that way”?

You are not alone. In healthcare, we learn a lot from our peers. However, there may be practices that are often outdated and may even be harmful to people who are at their most vulnerable. It’s time to change!

We are Margaret Ducharme, CNE OR and Heather Symons, Surgical Clinical Reviewer- ACS NSQIP at Ridge Meadows Hospital in Maple Ridge, BC. Marg had kick-started this campaign to encourage our staff to think about what they are doing in relation to their practice as well as to think about the impact on our patients: Why we do what we do rather than “because we’ve always done it that way” Heather compiled and presented the data that showed the positive trends in our campaign.

We have already started work on reducing Surgical Site Infections by a few simple changes that have made a substantial impact. The end goal is to take this campaign hospital wide to facilitate engaged thinking and doing within the framework of our standards.

So far we held QI sessions for the OR team where we posed the question: What are things you can change that are within your scope? (ORNAC/PRNABC, College)

About the speaker(s):

  • Ms. Margaret Ducharme, RN, CPN(c),
  • Heather Symons, RN, BN

Using Simulation to Manage Crisis Situations in Urologic Surgery

Abstract:

The Alberta Children’s Hospital facilitates a biannual Perioperative Crisis Management (POCM)[1] course. This is a multidisciplinary, inter-professional simulation based course using mannequins and task trainers in situ in the operating room. Participants include all the perioperative players including anesthesia, surgery, OR RNs, PACU RNs, and respiratory therapists. At the most recent course held on October 21st, 2017 urology was one of the surgical services involved. This course provided a unique opportunity for members of the urology surgical team to engage in simulated crisis situations that had been identified but our Quality Assurance and Improvement team as actual real-life cases that had previously occurred. Participants were blindly presented with 2 emergency patient scenarios: a local toxicity case due to an intravascular penile block and a pyeloplasty anaphylactic case with tension pneumothorax. This unique education opportunity fostered multidisciplinary relationships by allowing participants to practice skills required during a surgical crisis. Using the PEARLS (promoting excellence and reflective learning in simulation)[2] debriefing framework participants were further engaged to provide feedback on surgical processes and identify learning or systematic gaps. All players commented on the benefits of this course primarily related to improving team dynamics, communication and leadership in dealing with a patient crisis situation. It also provided urologists with a “safe” learning environment to evaluate surgical processes to enhance and improve patient safety. Learners identified areas of improvement from a personal and team-work perspective. The objective for the POCM faculty is to host another course specific to the urology specialty and identify ways

About the speaker(s):

Ms. Torey Erdman, RN, CNP (C), Alberta Health Services


Surgical TOA- "Let's Talk"

Abstract:

Woodstock Hospital is a Large Community Hospital in Southwestern Ontario that serves a population of 100,000 people.

Effective communication has been identified as a critical element in improving patient safety and reduces the need for patients and family to repeat information. The College of Nurses of Ontario (2008) defines transfer of accountability as “an interactive process of transferring client specific information from one caregiver to another or from one team of caregivers to another for the purpose of ensuring the continuity of care and the safety of the client.” When a face-to-face Transfer of Accountability (TOA) occurs at the patient’s bedside, there is an opportunity for the patient to be the “third voice” to ask questions and clarify information exchanged.

Woodstock Hospital Perioperative Staff were no different from their peers at surrounding hospitals, in that nursing staff all had varied practices and routines  of reporting surgical patient information at hand off of patient care. Some used the back of a patient label, others had developed small "Coles Notes" type of reporting; what was missing was consistency in communication. As a group we worked together to develop a Surgical Services Transfer of Accountability form which standardizes the communication shared and improves patient safety. 

About the speaker(s):

Ms. Janice Koekebakker, RN,BHScN,CPN,RNFA, Woodstock Hospital


Enhancing Perioperative Patient Safety:  A Collective Responsibility

Abstract:

Although perioperative healthcare professionals endeavor to provide high quality and safe patient care, paradoxically, the prevalence of adverse events in the perioperative setting is remarkable.  Whilst many adverse events are related to team dynamics, challenges to teamwork in the perioperative context are plentiful.  A research question was formulated: what is the quality of the evidence supporting a positive relationship between perioperative team training and patient safety?  A literature review identified articles associating a multidisciplinary perioperative team training intervention with patient safety outcomes of morbidity and mortality.  With evidence of moderate strength, team training interventions support positive outcomes for patients.  Safety checklists are practical for standardizing safety practices and contribute to solutions.  Wenger’s Communities of Practice and Gittell’s Relational Coordination theories offer opportunity to understand team interdependency.  Further considerations for enhancing a collective perioperative safety culture include team leadership, interprofessional education, and learning from adverse events.

About the speaker(s):

Mrs. Lynne Laflamme, RN, BScN, MHS, RNFA, CNOR, Alberta Health Services, Foothills Medical Center


National Surgical Quality Improvement Program (NSQIP) Driving Change in the OR at Oakville Trafalgar Memorial Hospital

Abstract:

In 2015, Halton Healthcare - Oakville Trafalgar Memorial Hospital (OTMH) was one of the first Ontario hospitals to join the National Surgical Quality Improvement Program (NSQIP).

Over the past 3 years, the surgery team at OTMH has made great strides in reducing their post-operative complication rates related to Catheter-Associated Urinary Tract Infections (CAUTI), Surgical Site Infections (SSIs) and Venous Thromboembolism (VTE). 

This poster will highlight the various strategies implemented, and how the the team used the NSQIP data to drive improvements in reducing post-op complication rates at OTMH. 

About the speaker(s):

Ms. Julie McBrien, RN, MHSc, Halton Healthcare


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